Abstract TMP88: Development Of An Interprofessional Pediatric Stroke Program Across A Fourteen Hospital Healthcare System In Southern California

Abstract

Background: An annual estimate of 1.0 to 2.0 in every 100,000 children are affected by stroke. The American Stroke Association (ASA) recommends the development of education programs to expand provider knowledge and establish systems to facilitate efficient pediatric stroke care. We embarked on establishing a regionwide, multidisciplinary pediatric stroke program consistent with the ASA goals of prompt recognition and management of stroke in pediatric patients across the organization’s 14 hospitals. Methods: In February 2020, we established a workgroup consisting of a stroke neurologist, pediatric physicians, stroke coordinators, clinical nurse specialists, nurse educators, clinical informaticists, and clinical nurses. The objectives were to standardize the pediatric stroke algorithms for the inpatient, emergency, and ambulatory settings; identify documentation tools specific for pediatric stroke; and develop education modules. The primary goal was immediate specialty consultation and transfer of pediatric stroke patients to the appropriate level of care. Nursing flowsheets were enhanced to include the Pediatric NIH Stroke Scale. The pediatric stroke education was designed as a multimodal program tailored for each professional role and work area. Education was implemented utilizing strategic methods to initiate (interactive online modules), reinforce (huddles, skills day), and sustain (annual updates) knowledge on pediatric stroke recognition, escalation, and management. Results: The organization’s pediatric stroke algorithms, documentation tools, and online modules raised awareness on this low-volume, high-risk pediatric condition. It is anticipated that referrals to the regional telestroke and the comprehensive stroke center will increase, resulting in timely treatment and better outcomes. Conclusion: Development of a regionwide pediatric stroke program requires the support and commitment from leadership and clinical stakeholders. Next steps for the organization’s pediatric stroke workgroup will include establishment of quality metrics relevant to pediatric stroke, including timeliness of subspeciality assessment and transfers, and initiation of emergent interventions.